PMID- 19570771
OWN - NLM
STAT- MEDLINE
DCOM- 20091214
LR  - 20220310
IS  - 1468-2079 (Electronic)
IS  - 0007-1161 (Print)
IS  - 0007-1161 (Linking)
VI  - 93
IP  - 12
DP  - 2009 Dec
TI  - Pain in ischaemic ocular motor cranial nerve palsies.
PG  - 1657-9
LID - 10.1136/bjo.2008.155150 [doi]
AB  - AIM: Pain is a common feature of microvascular ischaemic ocular motor cranial 
      nerve palsies (MP). The natural history of pain in this condition has not been 
      studied. The purpose of this report is to define the spectrum of pain in isolated 
      MP, with special reference to diabetic versus non-diabetic patients. DESIGN AND 
      METHODS: Retrospective and prospective chart review was performed on 87 patients 
      with acute-onset MP of a single cranial nerve (CN III, oculomotor; CN IV, 
      trochlear; CN VI, abducens) that progressively improved or resolved over 6 
      months. RESULTS: Five of the 87 patients had two events, making the total number 
      events 92. There were 39 (42.4%) CN III palsies, five (5.4%) CN IV palsies and 48 
      (52.2%) CN VI palsies. Thirty-six (41%) patients had diabetes. Pain was present 
      in 57 (62%) events. The majority of diabetic and non-diabetic patients had pain. 
      Pain preceded diplopia by 5.8 (SD 5.5) days in one-third of events. There was a 
      trend towards greater pain with CN III palsies, but this was not statistically 
      significant. Patients who experienced severe pain tended to have pain for a 
      longer duration (26.4 (SD 21.7) days compared with 10.8 (SD 8.3) and 9.5 (SD 9) 
      days for mild and moderate pain, respectively). There was no correlation between 
      having diabetes and experiencing pain. CONCLUSIONS: The majority of MP are 
      painful, regardless of the presence or absence of diabetes. Pain may occur prior 
      to or concurrent with the onset of diplopia. Non-diabetic and diabetic patients 
      presented with similar pain characteristics, contrary to the belief that diabetic 
      patients have more pain associated with MP.
FAU - Wilker, S C
AU  - Wilker SC
AD  - Department of Ophthalmology, University Hospitals of Cleveland, Cleveland, Ohio, 
      USA.
FAU - Rucker, J C
AU  - Rucker JC
FAU - Newman, N J
AU  - Newman NJ
FAU - Biousse, V
AU  - Biousse V
FAU - Tomsak, R L
AU  - Tomsak RL
LA  - eng
GR  - P30 EY006360/EY/NEI NIH HHS/United States
GR  - P30 EY006360-25/EY/NEI NIH HHS/United States
GR  - R21 EY015145-03/EY/NEI NIH HHS/United States
GR  - R21 EY015145/EY/NEI NIH HHS/United States
GR  - P30-EY06360/EY/NEI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20090630
PL  - England
TA  - Br J Ophthalmol
JT  - The British journal of ophthalmology
JID - 0421041
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Diabetic Neuropathies/complications
MH  - Female
MH  - Humans
MH  - Ischemia/*complications
MH  - Male
MH  - Middle Aged
MH  - Oculomotor Nerve/blood supply
MH  - Oculomotor Nerve Diseases/*complications
MH  - Pain/*etiology
MH  - Pain Measurement
MH  - Prospective Studies
MH  - Retrospective Studies
PMC - PMC2998753
MID - NIHMS239347
COIS- Competing interest: none declared.
EDAT- 2009/07/03 09:00
MHDA- 2009/12/16 06:00
PMCR- 2010/12/08
CRDT- 2009/07/03 09:00
PHST- 2009/07/03 09:00 [entrez]
PHST- 2009/07/03 09:00 [pubmed]
PHST- 2009/12/16 06:00 [medline]
PHST- 2010/12/08 00:00 [pmc-release]
AID - bjo.2008.155150 [pii]
AID - 10.1136/bjo.2008.155150 [doi]
PST - ppublish
SO  - Br J Ophthalmol. 2009 Dec;93(12):1657-9. doi: 10.1136/bjo.2008.155150. Epub 2009 
      Jun 30.